CONVENTIONAL APPROACHES often don't lower triglycerides to guideline-recommended levels1–4
With conventional triglyceride-lowering approaches (e.g., statins, fibrates, and omega-3 fatty acids), people with Familial Chylomicronaemia Syndrome (FCS) still face a high risk of acute pancreatitis1–4
A strict, low-fat diet is the cornerstone of treatment in FCS5
Current FCS management primarily includes the use of an extremely low-fat diet (20–25 g/day) and avoidance of alcohol to manage high triglycerides.6 This remains essential for managing FCS symptoms and reducing the risk of acute pancreatitis, especially as conventional approaches show limited efficacy6
CONVENTIONAL TRIGLYCERIDE-LOWERING APPROACHES are limited1–3
Conventional approaches have not been shown to lower the risk of acute pancreatitis in people with extremely high triglyceride levels. Their efficacy is limited, as most activate lipoprotein lipase, which is missing or nonfunctional in people with Familial Chylomicronaemia Syndrome (FCS)1,3,7
Limitations of conventional approaches
Statins
Statins may be useful in protecting against atherosclerotic cardiovascular disease; however, they show limited efficacy in people with FCS and do not lower acute pancreatitis risk2,3,6,8
Fibrates
Fibrates induce triglyceride clearance by activating lipoprotein lipase; however, due to the loss of lipoprotein lipase activity in people with FCS, the clinical benefit of fibrates is minimal2,6,8
Eicosapentaenoic Acid (EPA)
EPA, an omega-3 fatty acid, has been shown to moderately reduce triglyceride levels caused by other diseases but are not effective for people with FCS3–6,8
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Not an actual patient
Targeted treatment is an option for people with FCS1,2,9
Conventional triglyceride-lowering approaches are focused on increasing lipoprotein lipase activity. However, given the lack of functional lipoprotein lipase activity in people with FCS, increased apolipoprotein C-III levels primarily lead to further increased triglyceride levels via lipoprotein lipase-independent pathways7,10
As a result, most people do not achieve the guideline-recommended triglyceride target of ≤10 mmol/L (880 mg/dL), leaving them at high risk of acute pancreatitis3,4,7,9
Apolipoprotein C-III is a recognised target for specialist therapies aiming to lower triglycerides in people with FCS. Volanesorsen is an EU-approved antisense oligonucleotide that targets hepatic apolipoprotein C-III mRNA2,11,12
How could achieving the guideline-recommended triglyceride target benefit people with FCS?
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Abbreviations
AP, acute pancreatitis; FCS, Familial Chylomicronaemia Syndrome.
Show References
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- Gouni-Berthold I. J Endocr Soc. 2020;4(2):bvz037.
- Mach F, Baigent C, et al. Eur Heart J. 2020;41(1):111–88.
- Shamsudeen I, Hegele RA, et al. Expert Rev Clin Pharmacol. 2022;15(4):395–405.
- Stroes E, Moulin P, et al. Atheroscler Suppl. 2017;23:1–7.
- Davidson M, Stevenson M, et al. J Clin Lipidol. 2018;12(4):898–907.
- Veliadkis N, Stachteas P, et al. Pharmaceuticals (Basel). 2024;17(5):568.
- Wolska A, Yang ZH, et al. Curr Opin Lipidol. 2020;31(6):331–9.
- Witztum JL, Tsimikas S, et al. J Clin Lipidol. 2023;17(3):342–55
- Goldberg RB, Chait A, et al. Front Endocrinol (Lausanne). 2020 Oct 23;11:593931.
- Larouche MB, Watts GF, et al. Curr Opin Endocrinol Diabetes Obes. 2025;32(2):75–88.